Provider First Line Business Practice Location Address: 
1 MEDICAL CENTER DRIVE
    Provider Second Line Business Practice Location Address: 
RUBY MEMORIAL HOSPITAL
    Provider Business Practice Location Address City Name: 
MORGANTOWN
    Provider Business Practice Location Address State Name: 
WV
    Provider Business Practice Location Address Postal Code: 
26506
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
304-598-8971
    Provider Business Practice Location Address Fax Number: 
304-598-4665
    Provider Enumeration Date: 
12/23/2014